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Bradykinin production during donor plasmapheresis procedures
P Perseghin1, M Capra, V Baldini
1Servizio di Immunoematologia e Trasfusionale, Unità di Aferesi, Ospedale San Gerardo de' Tintori, Monza (MI), Italy. ppersegh@tin.it
Vox Sanguinis
|August 25, 2001
Summary
Donors taking angiotensin-converting enzyme (ACE) inhibitors experienced higher bradykinin (BK) levels during plasmapheresis. This finding may explain hypotensive reactions in patients receiving apheresis therapy.
Area of Science:
- Cardiovascular Physiology
- Hematology
- Biochemistry
Background:
- Artificial surfaces in extracorporeal circuits can activate blood components.
- Bradykinin (BK) production is linked to hypotensive reactions in patients on ACE inhibitors or receiving platelet transfusions.
- The role of BK in donor plasmapheresis is not well understood.
Purpose of the Study:
- To investigate bradykinin (BK) production during donor plasmapheresis.
- To compare BK levels in donors taking ACE inhibitors versus those not taking them.
Main Methods:
- Eighteen volunteer donors, nine on ACE inhibitors, underwent plasmapheresis.
- Blood pressure was monitored pre- and post-procedure.
- Plasma BK concentrations were measured using competitive enzyme immunoassay (EIA).
- Thawed plasma units were also analyzed for BK.
Main Results:
- Donors on ACE inhibitors exhibited greater systolic blood pressure variations.
- Significantly higher BK concentrations were found in donors taking ACE inhibitors compared to controls (183 vs. 82 ng/ml post-first cycle, P < 0.0001).
- BK was detected in thawed plasma units from both groups, with higher levels in units from ACE inhibitor users.
Conclusions:
- Plasmapheresis in donors taking ACE inhibitors leads to elevated BK levels.
- The presence of BK in plasma units, especially after freeze-thaw, could explain hypotensive reactions during therapeutic plasma exchange.
- Further research is needed to determine the clinical significance of BK in plasma units.